文献詳細
特集 Common Disease インストラクションマニュアル―患者に何をどう説明するか
循環器疾患
文献概要
心房細動および心房粗動は致死的な不整脈ではないが,これによる頻脈が持続すると心不全が生じやすく,60歳未満でも高血圧,糖尿病,心機能低下,一過性脳虚血発作や脳梗塞の既往のどれかがあれば,脳梗塞を発症しやすい.これらの危険因子のある例や60歳以上の心房細動例では,脳梗塞予防のためのワルファリンを服用し,INRを2.0前後に保つ.心拍数が130/分以上の例では,房室結節伝導を抑制して心拍数の調節を行う.
参考文献
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2) The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Investigators:A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med 347:1825-1833, 2002
3) Hohnloser SH, Kuck KH, Lilienthal J, for the PIAF Investigators:Rhythm or rate control in atrial fibrillation─Pharmacological Intervention in Atrial Fibrillation (PIAF);A randomised trial. Lancet 356:1789-1794, 2000
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